ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo compare the relationship between vasomotor symptoms (hot flushes and night sweats) and depression in perimenopausal women with that in postmenopausal and older premenopausal women.DesignQuestionnaire data assessing current depressive symptoms (Center for Epidemiologic Studies Depression Scale), hot flushes, night sweats, menopausal status, depression history, hormonal therapy use, and demographic characteristics were collected from women aged 40 to 60 years seeking primary care. Multivariable logistic regression models were used to examine the relationship between vasomotor symptoms and depression.ResultsDepression (defined by a Center for Epidemiologic Studies Depression Scale score ≥ 25) was observed in 14.9% of 141 perimenopausal women, 13.9% of 151 postmenopausal women, and 7.6% of 184 older premenopausal women. Recent vasomotor symptoms were reported by 53.9% of perimenopausal women, 43.7% of postmenopausal women, and 20.7% of older premenopausal women. Perimenopausal women with vasomotor symptoms were 4.39 times more likely to be depressed than those without vasomotor symptoms (95% CI, 1.40-13.83), an association that did not change after controlling for depression history. In contrast with perimenopausal women, postmenopausal and older premenopausal women with vasomotor symptoms did not have a significantly greater risk for depression than women of the same menopausal status without vasomotor symptoms (adjusted odds ratios, 1.28 and 1.77; 95% CI, 0.47–3.46 and 0.53–5.89, respectively).ConclusionsHot flushes and night sweats are associated with depression in perimenopausal women. Further investigation is warranted to elucidate the mechanism by which hot flushes may be associated with depression in perimenopausal women and not in postmenopausal or older premenopausal women.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo determine if core body temperature (Tc) fluctuations occur in asymptomatic as well as symptomatic postmenopausal women.DesignTcwas recorded with an ingested radiotelemetry pill in symptomatic postmenopausal women who had a hot flash in the laboratory, in symptomatic women who did not have a hot flash in the laboratory, and in asymptomatic postmenopausal women.ResultsThere were no significant differences in mean Tcor Tcvariation, as measured by the standard deviation, among the three groups.ConclusionTcfluctuations are not unique to symptomatic postmenopausal women.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveQuality of life (QOL) is an outcome variable requiring measurement in clinical care or pivotal regulatory trial research. Current menopause QOL measures are mostly life phase or disease symptom inventories or scores. Believing that QOL should refer more to “sense of well-being,” we have developed the Utian QOL scale (UQOL) that is strongly based on perception of sense of well-being as distinct from menopausal symptoms.DesignA pool of items sampling various aspects of well-being was developed. Peri- and postmenopausal women (n= 327) responded to the items, and their responses were subjected to a factor analysis. Four factors emerged, each representing a QOL domain. The resulting 23-item instrument was validated in a geographically and socioeconomically diverse sample of peri- and postmenopausal women using the Short Form-36, an established, frequently used QOL inventory. QOL domains were subjected to confirmatory factor analyses, formal item analysis was completed, and the measure was assessed for reliability and validity, including a second sample of women (n= 270).ResultsWomen (n= 597; mean age, 52.9 years) from 12 communities across the United States completed the measure. The UQOL seems to reflect four components of QOL: occupational QOL, health QOL, emotional QOL, and sexual QOL. The questionnaire and scoring system are presented.ConclusionWe are reporting on the process of validating an instrument for quantifying sense of well-being in a perimenopausal population. Substantial reliability and validity estimates for the scale and its subscales support the UQOL as a valuable new tool for use in clinical research and practice.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveMenopause and aging are associated with a marked increase in the incidence of coronary heart disease as well as reductions in circulating estrogen, progestogen, and androgen levels. The synthetic compound tibolone and its metabolites have estrogenic, progestogenic, and androgenic characteristics. In the present study, we compared the effects of tibolone, estrogen replacement therapy, and estrogen plus progestogen replacement therapy on arterial and hepatic lipid accumulation and on circulating soluble adhesion molecule and endothelin-1 concentrations in surgically postmenopausal cynomolgus monkeys.DesignAnimals were fed an atherogenic diet for 2 years while receiving either no hormone treatment (control,n= 31) or the following treatments at doses designed to mimic the human dose on a daily caloric intake basis: tibolone at 2.5 mg/day (HiTib,n= 31), tibolone at 0.625 mg/day (LoTib,n= 29), conjugated equine estrogens (CEE) alone at 0.625 mg/day (CEE,n= 29), or CEE plus continuous medroxyprogesterone acetate (MPA) at 2.5 mg MPA/day (CEE + MPA,n= 30).ResultsRelative to the control group, iliac artery total cholesterol content was not different in the HiTib, LoTib, and CEE + MPA groups but was significantly lower in the group receiving CEE only (P< 0.05). In contrast, hepatic free cholesterol content was reduced in all treatment groups [HiTib (P< 0.01), LoTib (P< 0.05), CEE (P< 0.01), and CEE + MPA (P< 0.05)], whereas hepatic total and esterified cholesterol content were reduced in the HiTib, CEE, and CEE + MPA groups (allP< 0.05). HiTib and CEE groups had lower hepatic triglyceride levels per milligram of protein (P< 0.05). Iliac arterial cholesterol content was highly correlated with hepatic cholesterol content and with previously published histomorphometrically determined coronary artery atherosclerosis, supporting the use of the iliac artery as a surrogate for the coronary artery in the monkey. Circulating levels of soluble vascular cell adhesion molecule-1 were significantly reduced in the HiTib (P< 0.02) and CEE (P< 0.05) groups, whereas soluble E-selectin was reduced in the CEE group only (P< 0.01). Plasma endothelin-1 was significantly reduced in the LoTib (P< 0.05), CEE (P< 0.01), and CEE + MPA (P< 0.01) groups.ConclusionsThese results suggest that while tibolone caused marked depression of high-density lipoprotein cholesterol and a resultant twofold increase in the total plasma cholesterol/high-density lipoprotein cholesterol ratio, those effects did not result in exacerbation of iliac artery atherosclerosis, perhaps because of beneficial effects on vascular biology or hepatic metabolism.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo measure the effects of 2 years of treatment with tibolone on the breasts of cynomolgus macaques (Macaca fascicularis) in comparison with conventional hormone replacement therapy.DesignOvariectomized cynomolgus macaques were randomized into five groups and treated for 2 years. Groups included controls (n= 31) and four drug treatments, including tibolone at 0.05 mg/kg (LoTIB,n= 30) or 0.2 mg/kg (HiTIB,n= 31), conjugated equine estrogens at 0.042 mg/kg (CEE,n= 28), or CEE + medroxyprogesterone acetate (MPA) at 0.167 mg/kg (CEE + MPA,n= 29). Endpoints included histologic, histomorphometric, and immunohistochemical assessment of the mammary gland.ResultsTibolone did not cause stimulation of the breast in contrast to distinct proliferative responses of the breast to CEE and CEE + MPA, as measured by increases in breast epithelial tissue area and expression of the proliferation marker Ki67 in breast epithelial cells. Tibolone at the higher dose increased progesterone receptor expression in the breast relative to controls, indicating partial estrogen-agonist activity, but without induction of proliferation. Progesterone receptor expression was also induced by CEE.ConclusionsTibolone may have an advantage over conventional hormone replacement therapy because it does not stimulate proliferation in the breast. This lack of mammotrophic effect may reflect a lower risk for promotion of breast cancer.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe use of modulators of estrogen receptors activation is receiving increasing interest in menopausal medicine. Pure antiestrogens define a group of compounds exhibiting universal antagonistic properties. Nevertheless, we cannot disregard the possibility that they may still have some agonistic actions. Because estradiol (E2) has antioxidant properties, we tested the antioxidant capacity of two pure antiestrogens, ICI 182780 and EM-652 (SCH 57068).DesignThe ability of both compounds to protect isolated low-density lipoproteins against copper-induced oxidation in vitro was used as an index of their antioxidant properties.ResultsWhen compared with control (vehicle alone), ICI 182780 and EM-652 significantly increased the lag time of low-density lipoprotein oxidation when present at concentrations of 10 and 0.5 &mgr;M or greater, respectively. When compared with estrogens, ICI 182780 was as effective as E2at the lower concentrations tested (0.1 and 1 &mgr;M) but less effective at higher concentrations. EM-652 had similar antioxidant potency as E2but exerted maximal effects at lower concentration. Combined exposure to E2and each of the antiestrogens resulted in a higher antioxidant effect than that of antiestrogen alone. Another estrogen (estrone), and selective estrogen-receptor modulators, such as tamoxifen and hydroxytamoxifen, displayed an antioxidant potency that was close to ICI 182780 but lower than EM-652. Progestogens, such as progesterone or medroxyprogesterone acetate, had no antioxidant effect.ConclusionsBoth ICI 182780 and EM-652 exhibited potent antioxidant activity, which could have important biological implications.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveOur objective was to estimate the difference in bone mass at clinically relevant sites within female twin pairs who were discordant for use of hormone replacement therapy (HRT).MethodsWe studied 46 female twin pairs who were discordant for HRT use. Bone mineral content and density were measured at the lumbar spine, total hip, femoral neck, 13total forearm, and the total body. HRT use, calcium intake, physical activity, alcohol intake, and lifetime smoking were determined by questionnaire.ResultsWithin a pair, lumbar spine bone mineral density was significantly greater in past and current HRT users compared with nonusers (6.2% ± 2.0%;P= 0.006). In those pairs who were currently using HRT, the within-pair difference in lumbar spine bone density was 7.8% ± 2.1% (P= 0.002), and a significant within-pair difference in forearm bone density (5.1 ± 2.1%;P= 0.02) was apparent. A significant difference (4.6%;P= 0.03) was observed in total body bone mineral content when an adjustment was made for age, lean mass, fat mass, and height.ConclusionsIn keeping with randomized clinical trial findings, these results indicate that HRT in routine clinical use protects significantly against menopausal bone loss at the lumbar spine and the forearm. Our results also quantify the magnitude of the benefit of HRT on bone density that might be anticipated in clinical practice.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThis study attempted to estimate the mean age at menopause and also characterize and quantify its types and frequencies in Greek women who have recently become postmenopausal.DesignA retrospective analysis of hospital records was used to record the frequency of natural, spontaneous or induced premature, and delayed natural menopause; the mean age at menopause of each group; and their possible interrelationships with major events of reproductive history in 1,747 women visiting an endocrine clinic 1 to 5 years after menopause. A group of 438 postmenopausal women drawn from 4,000 cases from the nongynecological clinics of this hospital comprised the control group.ResultsNatural menopause was found in 1,333 (76.3%) women with a median age of 51 (95% CI, 50.8-51.2) and mean ± SD of 48.7 ± 3.8 years. Medically induced menopause after the age of 40 was recorded in 204 women (11.7%), spontaneous premature in 127 (7.1%), medically induced premature in 60 (3.7%), and delayed menopause in 26 (1.5%), with mean ages of 43.6 ± 1.7, 35.1 ± 3.3, 37.2 ± 1.6, and 59.6 ± 2.1 years, respectively. No significant differences in mean age at menopause or its types were noted between the two groups. Furthermore, no significant correlations among the parameters examined could be demonstrated except between smoking and age at menopause in the spontaneous premature menopause subgroup (P< 0.05). Finally, ovarian autoantibodies were found in 6.7% of the tested women with premature menopause.ConclusionsNatural menopause occurred at a mean age of 48.7 years in Greek women, who displayed an unexpectedly high prevalence of spontaneous or induced premature cessation of menstruation.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID